Hospital ethics committees have evolved as a response to complicated legal, ethical, and social dilemmas that accompany modern medicine. In the United States, their growth has been augmented by Joint Commission for the Accreditation of Healthcare Organizations standards and the Patient Self-Determination Act. There appears to be an implicit presumption that all clinical ethics consultation practices are relatively similar. Finally, there is heightened awareness of the needs for quality standards and assessment of the outcomes of ethics consultations.

Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

A few weeks ago, a rural hospital administrator phoned with a question posed by his management team. “If you were going to give us some ethics resources,” he queried, “just exactly what would they...

Clinical research is increasingly conducted in settings that include private physicians’ offices, clinics, community hospitals, local institutes, and independent research centers. The migration of such research into this new, non–academic environment has brought new cadres of researchers into the clinical research enterprise and also broadened the pool of potential research participants. Regulatory approaches for protecting human subjects who participate in research have also evolved. Some institutions retain their own Institutional Review Boards (IRBs), but Independent IRBs, community hospital IRBs and community–based (...) IRBs also fulfill oversight responsibilities. This article sheds light on this evolving world by discussing the findings gleaned from two studies: a study of the decision making processes used by members who serve on different kinds of IRBs and a study of the decision making processes employed by research participants. The article then discusses how the key findings may inform proposed revisions to the Common Rule. (shrink)

The ramifications of including genetic components in the clinical studies conducted in non-academic settings create unique ethical challenges. We used a qualitative research design consisting of semi-structured interviews that took place between October 2010 and September 2012. The sample consisted of 80 participants − 38 physicians and 42 coordinators − who worked across a number of different settings, including clinics, private practices, small hospitals, free standing research centers, and blended hospital-institutes in both rural and urban communities in 13 states across (...) the United States. The respondents primarily conducted industry sponsored trials and recruited their own patients as research participants. A majority of the respondents (65%) reported that most of the studies they conducted included an additional genetics component, and so participants were asked to donate specimens for genomics or biobanking. While genomics association studies were perceived as being of benefit, awareness of ethical implications associated with such studies was limited. The rapid advances in genetic technologies make it hard for clinicians and coordinators to help patients make informed decisions about participating in clinical research, and underscore the need to ensure that the regulations governing research on human subjects keep pace with the social and technological changes. It seems essential to discern legitimate ethical concerns and find ways to convey what is going on, what is possible and what might not be possible in terms of protecting privacy, anonymity, and confidentiality. (shrink)

Over the past 20 years, clinical research has migrated from academic medical centers to community-based settings, including rural settings. This evolving research environment may present some moral hazards or challenges that could undermine traditionally accepted standards for the protection of human subjects. The study described in this article was designed to explore the influence of motives driving the decisions to conduct clinical trial research in rural community settings. The researchers conducted semi-structured interviews with 80 participants who conducted clinical trials with (...) rural subjects. The interviews provided a way to examine the influence of budgetary factors when deciding to conduct a clinical study, how information about the budget and the purpose of the study is conveyed to research participants, and the potential willingness of clinicians and coordinators to enroll in the kinds of studies they offer. The findings suggest that clinical trial research in rural communities may challenge clinicians’ abilities to balance the needs of the patient with the needs of the research enterprise. Few respondents seemed to recognize the traditionally recognized hazards of a dual relationship, specifically the moral risks of trying to attend to the interests of both patient and industry. It seems important to re-examine how we protect human subjects and what such protection should look like as research becomes part of the way medical care is provided, even in very rural areas. (shrink)

Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

This book, formed as a series of essays in honour of Professor Carl Baudenbacher, addresses the very art of judicial reasoning, and features contributions from many of the foremost current or former national, supranational, or international judges. This unique volume is intended first and foremost for legal scholars, but its approachable style makes it readily accessible for students and for those with a general interest in the application of the law and justice in today's multi-layered world. The collection of essays (...) is rather more philosophical and reflective as opposed to doctrinal. Each contribution focuses on the nature and operation of justice, the independence of the judiciary, and on judicial style primarily from the perspective of the judges themselves. The book provides perspectives on what it means to be accountable and independent as a judge, the role of language and languages in the quest for justice, while other contributions acquaint readers with the some of the structures of courts themselves, or indeed question for whom judgments are written. Each chapter has been written by a presiding judge, or head of an institution and the book is divided into three parts: - Part I Art and Method - Part II Justice and the Judiciary - Part III Reasoning and Language(s). (shrink)

While rooted in careful study of Mead’s original writings and transcribed lectures and the historical context in which that work was carried out, the papers in this volume have brought Mead’s work to bear on contemporary issues in metaphysics, epistemology, cognitive science, and social and political philosophy.

In the influential 1995 article “Social Conditions as Fundamental Causes of Disease,” Bruce Link and Jo Phelan described social and political factors as “fundamental causes” of death and disease. Whitney Pirtle has recently declared racial capitalism another such fundamental cause. Using the case of the water crisis in Flint, Michigan, she has argued that racial capitalism's role in that situation meets each of the criteria Link and Phelan's article outlines: racial capitalism influenced multiple disease outcomes, affected disease outcomes through multiple (...) risk factors, involved access to flexible resources that can be used to minimize both risks and the consequences of disease, and was reproduced over time through the continual replacement of intervening mechanisms. We argue for Pirtle's conclusion using the extensive literature on racial capitalism and case studies concerning housing in the United States and Brazil and what Naomi Klein has termed “corona capitalism” in India. If races correspond to hierarchies of material security, as suggested by Ruth Wilson Gilmore, then these hierarchies and their causal effects are fundamental determinants of public health. (shrink)

Providing efficient and clean power is a challenge for devices that range from the micro to macro in scale. Although there has been significant progress in the development of micro-, meso-, and macro-scale power supplies and technologies, realization of many devices is limited by the inability of power supplies to scale with the diminishing sizes of CMOS-based technology. Here, the authors provide an overview of piezoelectric energy harvesting technology along with a discussion of proof of concept devices, relevant governing equations, (...) and figures of merit. They present two case studies: (a) energy capture from the operation of a novel shear and elastic modulus indentation device subjected to applied voltage and (b) energy capture from vibrating commercial bimorph piezoelectric structures mounted on household appliances. Lastly, areas of development needed for realization of commercial energy harvesting devices are suggested. (shrink)

The article surveys German-language ayurvedic cooking and nutrition books from 1990 until today. The semantic analysis reveals a market diversification that corresponds to the following categories: health, diet, spirituality, and individualism. These are main attractors of Ayurveda along with its promises of holistic balance and cosmological integration. Because this development can be interpreted as a reaction to the Western scientific formation of "Ayurveda" within popular life advice literature, this essay uses the concept of reflexive nutrition as derived from M. Stausberg's (...) reflexive ritualization. Furthermore, the success of these books indicates an absence of Christian dietetics in Germany's religion landscape. (shrink)

Domain analysis is useful for examination of individual spheres of intellectual activity, both academic and otherwise, and has been used in the knowledge organization (KO) literature to explore specific communities and uses, including web pornography (Beaudoin and Ménard 2015), virtual online worlds (Sköld, Olle 2015), gourmet cooking (Hartel 2010), healthy eating (McTavish 2015), art studies (Ørom 2003), the Knowledge Organization journal (Guimarães et al. 2013), and domain analysis itself (Smiraglia 2015). The results of domain analyses are useful for the development (...) of controlled vocabularies, taxonomies, ontologies, metadata schemas, and other systems for the documentation, description, and discovery of resources, as well as for knowledge discovery in general (Smiraglia 2015; Hjørland 2017). This research describes a methodology for the elucidation of knowledge organization systems (KOS) currently in use on image websites that document graffiti, graffiti art, and street art around the world. (shrink)

Background: There are few standardized measures available to assess executive function in a naturalistic setting for children. The Children’s Cooking Task is a complex test that has been specifically developed to assess EF in a standardized open-ended environment. The aim of the present study was to evaluate the internal consistency, inter-rater reliability, sensitivity and specificity, and also convergent and divergent validity of the Norwegian version of CCT among children with pediatric Acquired Brain Injury and healthy controls.Methods: The present study has (...) a cross-sectional design, based on baseline data derived from a multicenter RCT. Seventy-five children with pABI from two university hospitals with parent-reported executive dysfunction and minimum of 12 months since injury/completed cancer therapy, as well as 59 HCs aged 10–17 years, were assessed with CCT using total errors as the main outcome measure. The pABI group completed tests assessing EF on the impairment level within the ICF framework, and on the participation level. In addition, they completed tests of intellectual ability, processing speed, attention, learning, and memory. Finally, overall functional outcome was evaluated for the children with pABI.Results: Acceptable internal consistency and good inter-rater reliability were found for the CCT. Children with pABI performed significantly worse on the CCT than the HCs. The CCT identified group membership, but the sensitivity and specificity were overall classified as poor. Convergent validity was demonstrated by associations between the CCT and performance-based tests assessing inhibition, cognitive flexibility, and working memory, as well as teacher-reported executive dysfunction. Divergent validity was supported by the lack of association with performance-based measures of learning and memory, attention, and verbal intellectual ability. However, there was a moderate association between the CCT and performance-based tests of processing speed. Lastly, better performance on the CCT was associated with a better functional outcome.Conclusion: Our study with a relatively large sample of children with pABI and HC’s demonstrated good psychometric properties of the CCT. CCT performance was associated with the overall level of disability and function, suggesting that CCT is related to the level of activity in everyday life and participation in society. Hence, our study suggests that the CCT has the potential to advance the assessment of EF by providing a valid analysis of real-world performance. Nevertheless, further research is needed on larger samples, focusing on predictors of task performance, and evaluating the ability of CCT to detect improvement in EF over time. The patterns of error and problem-solving strategies evaluated by the CCT could be used to inform neuropsychological rehabilitation treatmentand represent a more valid outcome measure of rehabilitation interventions. (shrink)

Talent and Education was first published in 1960. Minnesota Archive Editions uses digital technology to make long-unavailable books once again accessible, and are published unaltered from the original University of Minnesota Press editions.The problem of identification, development, and utilization of talented young people is a matter of prime concern to all who are interested in the welfare of the individual and the future of the nation. This book, constituting a progress report on research related to the problem, will be of (...) particular value to educators, psychologists, social workers, community leaders, and others who are engaged in the effort to make the most of our human resources.The volume contains chapters by a number of contributors drawn from various fields in elementary, secondary, and higher education. The contributors include John E. Anderson, Robert H. Beck, Florence N. Brumbaugh, Walter W. Cook, Willis E. Dugan, Dale B. Harris, Arthur J. Lewis, Catherine Cox Miles, Mary Pilch, Maynard C. Reynolds, Anne Roe, Merrill F. Roff, Paul C. Rosenbloom, Audrey Shechtman, and E. Paul Torrance. Orville L. Freeman, governor of Minnesota, writes an indtroduction.Among the topics discussed are the nature and scientific measurement of talent, the effects of life experiences on the development of talent, the enrichment of school curricula, special grouping and acceleration in the schools, psychological aspects of some of the problems, and Russian methods of dealing with individual differences. The volume is based on papers from an Institute on Exceptional Children held at the University of Minnesota. (shrink)

John Rawls says: “The main problem of distributive justice is the choice of a social system.” Property-owning democracy is the social system that Rawls thought best realized the requirements of his principles of justice. This article discusses Rawls’s conception of property-owning democracy and how it is related to his difference principle. I explain why Rawls thought that welfare-state capitalism could not fulfill his principles: it is mainly because of the connection he perceived between capitalism and utilitarianism.

An approach to argument macrostructure -- The dialectical nature of argument -- Toulmin's problematic notion of warrant -- The linked-convergent distinction, a first approximation -- Argument structure and disciplinary perspective : the linked-convergent versus multiple-co-ordinatively compound distinctions -- The linked-convergent distinction, refining the criterion -- Argument structure and enthymemes -- From analysis to evaluation.

Liberalism generally holds that legitimate political power is limited and is to be impartially exercised, only for the public good. Liberals accordingly assign political priority to maintaining certain basic liberties and equality of opportunities; they advocate an essential role for markets in economic activity, and they recognize government's crucial role in correcting market breakdowns and providing public goods. Classical liberalism and what I call “the high liberal tradition” are two main branches of liberalism. Classical liberalism evolved from the works of (...) Adam Smith and the classical utilitarian economists; its major 20th century representatives include Friedrich Hayek and Milton Friedman. The high liberal tradition developed from John Stuart Mill's works, and its major philosophical representatives in the 20th century are John Dewey and, later, John Rawls. This paper discusses the main distinguishing features of the classical and the high liberal traditions and their respective positions regarding capitalism as an economic and social system. Classical liberals, unlike high liberals, regard economic liberties and rights of private property in productive resources to be nearly as important as basic liberties. They conceive of equality of opportunity in more formal terms, and regard capitalist markets and the price system as essential not only to the allocation of production resources, but also as the fundamental criterion for the just distribution of income, wealth, and economic powers. High liberals, by contrast, regard the economic liberties as subordinate to the exercise of personal and civic liberties. They are prepared to regulate and restrict economic liberties to achieve greater equality of opportunities, reduce inequalities of economic powers, and promote a broader conception of the public good. And while high liberals endorse markets and the price system as essential to allocation of productive resources, they do not regard markets as the fundamental criterion for assessing just distributions of income, wealth, and economic powers and positions of responsibility. The paper concludes with some reflections upon the essential role that dissimilar conceptions of persons and society play in grounding the different positions on economic justice that classical and high liberals advocate. (shrink)

Mark Freeman's inspiring account of the burgeoning field of the psychological humanities presents a clear and compelling vision of what the discipline of psychology might become. Engaging and accessible, this bold, provocative book is destined to spark significant discussion and debate in audiences including advanced undergraduates, postgraduates, and professionals in the field of psychology with interests in theoretical and philosophical psychology.

This chapter contains section titled: Introduction A Global Distribution Principle? Problems with Globalizing the Difference Principle Conclusion Notes.